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Nervous  and  mental  Disease  monograph  Series  No.  n. 


The  Theory  of 
Schizophrenic  Negativism 


BY 

PROFESSOR   DR.  E.    BLEULER 

PROFESSOR   OF   PSVCHIATRY,    UNIVERSITY  OF   ZURICH  ;    DIRECTOR   OF  BURGHOLZLl    ASYLUM 

TRANSLATED  BY 

WILLIAM  A.  WHITE,  M.D. 

SUPBRINTKNDENT   OF  THE   GOVERNMENT  HOSPITAL   FOR   THE   INSANE,  WASHINGTON,  D.  C. 


NEW  YORK 

The  Journal  of  Nervous  and  Mental  Disease 

Publishing  Company 

1912 

Reprinted  with  the  permission  of  the  Original  PubHsher 

JOHNSON   REPRINT  CORPORATION     JOHNSON  REPRINT  COMPANY  LTD. 
1 1 1  Fifth  Avenue,  New  York,  N.Y.  10003     Berkeley  Square  House,  London,  W1X6BA 


First  reprinting  1970,  Johnson  Reprint  Corporation 
Printed  in  the  United  States  of  America 


Copyright  1912 

BY 

The  Journal  of  Nervous  and  Mental   Disease 


THE  THEORY  OF  SCHIZOPHRENIC  NEGATIVISM^ 


CONTENTS 


The  theories  of  negativism  that  have  been  advanced  hereto- 
fore are  incorrect  or  unsatisfying.  Negativism  is  a  complicated 
symptom,  having  in  some  cases,  many  cooperating  causes. 

The  predisposing  causes  of  negativistic  phenomena  are: 

1.  Ambitendency,  which  sets  free  with  every  tendency  a 
counter  tendency. 

2.  Ambivalency,  which  gives  to  the  same  idea  two  contrary 
feeling  tones  and  invests  the  same  thought  simultaneously  with 
both  a  positive  and  a  negative  character. 

3.  The  schizophrenic  splitting  of  the  psyche,  which  hinders 
the  proper  balancing  of  the  opposing  and  cooperating  psychisms, 
with  the  result  that  the  most  inappropriate  impulse  can  be  trans- 
ferred into  action  just  as  well  as  the  right  impulse  and  that  in 
addition  to  the  right  thought,  or  instead  of  it,  its  negative  can 
be  thought. 

4.  The  lack  of  clearness  and  imperfect  logic  of  the  schiso- 
phrenic thoughts  in  general  which  makes  a  theoretical  and  prac- 
tical adaptation  to  reality  difficult  or  impossible. 

On  the  ground  of  this  disposition  there  may  occur  direct 
negativistic  phenomena  in  such  a  manner  that  positive  and  neg- 
ative psychisms  replace  one  another  indiscriminately,  only  the 
incorrect  reactions  standing  out  as  pathological  negativism. 

*  E.  Bleuler,  Zur  Theorie  des  schizophrenen  Negativismus,  Psy- 
chiatrisch-Neurologische  Wochenschrift,  Vol.  12,  1910/11,  Nr.  18,  19,  20,  2r. 


2  THE   THEORY   OF    SCHIZOPHRENIC    NEGATIVISM 

As  a  rule,  however,  the  negativistic  reaction  does  not  appear 
merely  as  accidental,  but  as  actually  preferred  to  the  correct  re- 
action. 

In  ordinary  external  negativism  which  consists  in  the  nega- 
tion of  external  influences  (Ex,  Command)  and  of  what  one 
would  normally  expect  the  patient  to  do  (Ex.  Defaecation  in 
the  closet  instead  of  the  bed),  the  following  causes  are  at  work: 

(o)  The  autistic  withdrawing  of  the  patient  into  his  phanta- 
sies, which  makes  every  influence  acting  from  without  compara- 
tively an  intolerable  interruption.  This  appears  to  be  the  most 
important  factor.  In  severe  cases  it  alone  is  sufficient  to  produce 
negativism. 

(&)  The  existence  of  a  hurt  (negative  complex,  unfulfilled 
wish)  which  must  be  protected  from  contacts. 

(c)  The  misunderstanding  of  the  surroundings  and  their  pur- 
pose. 

{d)  Direct  hostile  relations  to  the  surroundings. 

{e)  The  pathological  irritability  of  the  schizophrenic. 

(/)  The  pressure  of  thought  and  other  difficulties  of  action 
and  of  thought,  through  which  every  reaction  becomes  painful. 

{g)  The  sexuality  with  its  ambivalent  feeling  tones  is  also 
often  one  of  the  roots  of  negativistic  reaction. 

Inner  negativism  (contrary  tendency  opposed  to  the  will, 
and  intellectually  opposed  to  the  right  thoughts)  is  accounted 
for,  in  large  part,  by  ambitendency  and  ambivalency,  which  in 
view  of  the  inner  splitting  of  the  thought  renders  intelligible  a 
slight  preference  for  the  negativistic  reaction.  Very  pronounced 
phenomena  of  inner  negativism  probably  have  other  cooperating 
causes,  which  we,  at  the  present  time,  do  not  know. 


THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM  3 

A  conclusive  explanation  of  all  negativistic  phenomena  would 
be  premature.  It  seems  to  me,  however,  that  the  falsity  or 
unsatisfactory  nature  of  the  theories  hitherto  erected  might  be 
demonstrated.  It  is  always  possible  to  discover  roots  of  nega- 
tivism in  other  directions  and  to  understand  genetically,  at  least, 
a  part  of  the  symptoms  grouped  together  under  this  name.  A 
better  attitude  is  gained  in  this  way  for  further  progress. 

At  this  point  we  must  first  make  clear  that  negativism  is  not 
a  unitary  symptom.  The  chief  and  predominating  group  is 
characterized  throughout  by  the  fact  that  the  patient,  by  outside 
influences,  by  command,  will  not  do  precisely,  what  under  normal 
conditions  would  be  expected  (passive  negativism)  ;  or,  that  he 
does  exactly  the  opposite  (active  negativism).  A  command  is 
not  executed,  most  often  after  a  clearly  repulsing  mimik.  If  one 
tries  to  bring  about  a  desired  movement  passively  (raise  the 
arm,  sit  up  to  slip  on  clothes)  they  show  opposition,  seek  to  get 
away,  resist  often  with  abuse  and  blows.  The  patients  will  not 
stand  up,  will  not  go  to  bed,  if  it  is  desired  of  them;  they  will 
not  sit  at  the  place  assigned  to  them,  will  not  eat  the  food  offered 
them,  they  take  the  soup  with  the  spoon  for  the  preserves,  and 
the  preserves  with  the  soup  spoon;  they  satisfy  natural  needs  out 
of  time  and  place.  From  simple  opposition  to  the  active  execu- 
tion of  the  opposite  of  what  is  expected  there  are  all  gradations. 

Not  even  this  circumscribed  group  gives  an  impression  of 
unity.  Most  patients  indeed  combine  their  negativistic  actions 
with  an  affect  of  irritability,  vexation,  anger.  This  emotional 
reaction  is,  however,  not  a  necessary  component.  If  the  nega- 
tivistic action  is  simply  the  contradiction  of  a  custom,  if  it  is 
not  interfered  with  from  without,  the  previous  mood  is  usually 
maintained;  the  patient  lies  down,  with  apparent  indifference,  in 


4  THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM 

the  bed  of  his  neighbor;  in  some  cases  one  sees  even  a  certain 
mirth  over  a  successful  trick.  Repression  first  awakes  irritability 
in  these  cases. 

Often  the  patients  maintain  their  indifference  in  spite  of 
opposition;  it  may  be  that  very  strongly  negativistic  patients 
are  permanently  euphoric  and  do  not  come  out  of  this  mood, 
while  they  resist  with  bites,  scratches,  and  blows  the  invitation 
to  shake  hands;  their  defense  is  sport  for  them  like  a  jolly  play. 
More  commonly  the  whole  behavior  looks  like  that  of  a  flirt; 
women  patients  watch  the  physician,  as  if  they  were  waiting  for 
him  to  offer  them  his  hand,  or  bring  forward  a  request,  so  that 
he  must  busy  himself  with  them,  and  then,  in  their  negation,  be- 
have like  a  maiden  who  stimulates  her  lover,  but  tries  to  appear 
as  if  she  were  keeping  him  off.  At  other  times  the  negativism 
has  a  plainly  erotic  character,  sometimes  in  the  agreeable  sense 
of  a  love-play,  sometimes  in  an  unpleasant  sense,  as  the  aversion 
to  an  attack,  and  often  in  both  directions  at  once. 

Besides  this  outer  negativism  there  is  also  an  inner,  which  most 
frequently  affects  the  will.  The  patient  can  not  do  exactly  what 
he  wishes  to  do.  In  the  stage  between  thought  and  expression  an 
inhibition,  a  contrary  impulse,  or  a  cross  impulse  can  make  the 
action  impossible.  So  we  see  patients  who  rush  to  take  a  prof- 
fered bit  of  food,  stop  half  way  between  plate  and  mouth,  and 
finally  refuse  the  morsel;  with  every  other  act  the  same  results 
follow.  If  they  start  to  shake  hands :  at  any  point  the  action  may 
not  only  stop  but  the  hand,  as  the  result  of  a  contrary  impulse, 
may  be  placed  behind  the  back. 

Often  the  patients  frustrate  the  results  of  an  act  by  other 
movements.  They  stretch  the  arm  out  in  order  to  proffer  the 
hand  but  flex  the  forearm  and  hand  so  that  the  hand  can  not  be 


THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM  $ 

taken;  or  on  the  request  to  show  the  tongue  they  put  it  out  but 
turn  away  the  head.  In  some  of  these  cases  of  simultaneous 
obedience  and  disobedience  one  usually  sees  the  external  negativ- 
ism. But  undoubtedly  the  phenomenon  occurs  as  a  pure  will-nega- 
tivism. I  have  noticed  it  when  the  patient  spontaneously  occupies 
himself  in  something  without  outside  invitation,  for  example 
in  eating;  mostly  I  have  observed  it  in  piano  playing.  They 
reach  out  for  the  stroke  and  strike  down  with  the  forearm,  but 
towards  the  end  of  the  movement  dorsally  flex  the  wrist  to  the 
maximum,  so  that  the  fingers  do  not  reach  the  keys,  or  the 
patient  turns  the  eyes  to  one  side,  in  order  to  observe  something, 
and  at  the  same  time  turns  the  head  to  the  other  side  (or  the 
reverse). 

Cross  impulses  assert  themselves,  in  that,  instead  of  a  willed 
or  begun  act  another  is  carried  out;  the  patient  starts  to  take  a 
spoon  (to  eat),  the  begun  movement  is  changed  however  and 
he  takes  the  fork,  puts  it  in  the  bread  basket  or  does  something 
else  equally  pecuHar.  These  cases  present  all  transitions  to  the 
apraxoid  appearances  of  schizophrenia,  which  on  their  side 
again  have  different  roots. 

Not  infrequently  negativism  shows  itself  towards  a  task 
which  has  already  been  completed.  The  patients  destroy  what 
they  have  made.  Sometimes  as  if  in  anger,  sometimes  as  if  from 
a  free  resolution,  sometimes  compulsively,  resenting  it  in  the 
doing. 

It  is  very  difficult  to  get  a  clear  idea  of  the  subjective  process 
of  this  will-negativism.  Very  few  patients  offer  any  explanation. 
It  is  certain,  nevertheless,  that  some  are  aware  of  the  disturbance, 
but  not  others,  and  that  all  possibilities  actually  occur  with  regard 
to  the  psychological  point  where  this  sets  in.     The  patients  sud- 


6  THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM 

denly  no  longer  will  what  they  have  just  intended,  or  they  sud- 
denly will  the  opposite ;  their  motive  may  come  into  consciousness 
or  not;  the  goal  idea  becomes  altered.  This  can,  however,  also 
remain  the  same,  while  the  centrifugal  impulse  becomes  disturbed 
somewhere  in  the  tract  z-m,  which  one  can  not  conceive  suffi- 
ciently long  and  complicated  (compare  for  example  Liepmann's 
researches  on  apraxia).  Here  the  patients  of  course  become 
more  or  less  aware  of  the  disturbance;  but  some  bear  it  with 
the  thoughtless  indifference  of  schizophrenia,  others  feel  it  as 
a  peculiarity  which  has  befallen  them,  and  conceive  it,  sometimes 
as  something  abnormal,  sometimes  as  an  influence  from  outside. 
Not  at  all  seldom  the  negativistic  impulse  is  transferred  into  hal- 
lucinations, which  then,  like  other  sensory  falsifications,  are  in- 
terpreted subjectively  in  the  most  varied  manner.  A  catatonic, 
for  example,  who  will  say  something,  hears  his  neighbor  com- 
mand, "  Hold  your  mouth."  Another,  who  will  €at,  the  voices 
forbid,  or  say,  it  would  not  be  right;  if  he  does  not  eat,  it  is  again 
not  right ;  he  asks  despairingly,  what  in  heaven's  name  he  may  do. 
To  a  third  the  voices  always  say  the  opposite  of  what  he  must  do. 
A  fourth  receives  hallucinatory  commands  for  example,  to  write 
a  letter ;  as  he  is  about  to  obey,  the  voices  forbid  him.  He  calls 
these  hallucinations  very  significantly  "  plus  and  minus  voices." 
There  is  probably  little  difference  in  principle  when  the  negativism 
is  transferred  into  delusions.  H  one  requests  such  a  patient  to 
eat,  stand  up,  walk,  he  does  not  do  it.  Afterwards  he  complains 
that  he  gets  nothing  to  eat,  that  the  physician  compels  him  to  lie 
in  bed,  forbids  him  to  walk.  The  commonest  negativistic  delu- 
sion is  in  general  that  the  patient  believes  it  is  forbidden  him 
(under  threats  of  danger  or  temporary  or  everlasting  punish- 
ment) to  do  what  he  wishes.     It  is  often  shown  from  the  change 


THE   THEORY   OF    SCHIZOPHRENIC    NEGATIVISM  / 

of  the  ideas  and  from  the  incorrect  or  artificial  causal  connection, 
that  the  delusion  is  in  reality  secondary,  springs  from  the  nega- 
tivistic  attitude,  and  so  only  apparently  accounts  for  the  negativ- 
istic  behavior. 

Intellectual  negativism,  negation  of  thought  content,  is  the 
least  known  of  all.  Naturally  it  can  only  become  perceptible 
as  opposite  thoughts ;  it  will  hardly  be  possible  to  demonstrate  the 
existence  of  a  mere  negativistic  resistance  against  the  contents 
of  the  thought.  We  find  patients,  who  for  each  thought  must 
think  the  opposite,  or  instead  of  a  thought,  imagine  its  negation 
or  its  opposite.  An  intelligent  and  philosophically  accomplished 
catatonic  said,  "If  one  utters  a  thought,  one  sees  always  the 
opposite  thought.  That  reinforces  itself  and  extends  so  quickly 
that  one  does  not  know  which  was  the  first."  Others  complain 
that  the  thought  comes  to  them  "that  is  cold."  when  they  touch 
something  warm,  and  the  like.  One  of  our  patients  who  was 
still  able  to  work  and  was  not  confused  had  at  times  lost  the 
f eeHng  for  positive  and  negative :  she  praised  and  found  fault 
with  her  possessions,  her  husband,  etc.  in  one  breath,  so  that  it 
was  not  possible  to  bring  out  what  she  really  meant. 

If  a  patient  retracts  his  own  declaration,  at  times  right  after- 
wards in  an  agitated,  pathetic  tone,  one  can  relate  it  just  as 
well  to  negativism  of  the  will  as  to  that  of  the  intelligence;  he 
has  come  to  the  institution  to  get  evidence — no,  he  wishes  no 
evidence ;  and  so  forth. 

In  intellectual  negativism  the  subjective  side  of  the  symptoms 
is  also  very  variable.  Many  patients  experience  negativistic 
thoughts  as  compulsory,  others  are  indiflferent,  and  again  others 
do  not  notice  it  at  all.  This  form  of  negativism  is  also  often  pro- 
jected as  hallucinations;  the  patients  then  often  hear  the  opposite 


8  THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM 

of  what  they  think  or  what  they  perceive  in  the  outer  world.  It 
may  also  sometimes  occur  that  the  negativistic  thought  at  its  in- 
ception is  transferred  into  compulsive  actions  so  that  the  patients 
must  say  the  opposite  of  what  in  reality  they  think. 

Occasionally  intellectual  negativism  affects  only  the  speech 
mechanism.  The  patients  say  the  opposite  of  what  they  wish  to 
say,  especially  they  express  against  their  will  a  negation,  when  in 
reality  an  affirmation  was  thought.  "  You  are  not  a  wretch," 
may  be  said  to  the  physician,  as  a  resume  of  a  prolonged  abuse 
for  unjust  confinement.  One  catatonic  who  was  told  to  step  up 
on  a  platform  in  the  clinic  protested  energetically  that  she  would 
not  "  go  down  there."  Patients  do  not  by  any  means  always 
notice  such  mistakes,  not  even  when  one  tries  to  call  them  to 
their  attention. 

Probably  it  is  a  milder  form  of  this  same  anomaly  when 
the  patient  expresses  the  correct  idea  but  in  an  unexpected  nega- 
tive form:  "that  is  not  beautiful"  for  "that  is  ugly";  "that  is 
not  ugly "  for  "  that  is  beautiful."  In  one  case,  which  I  have 
been  able  to  observe  for  many  years,  such  negative  expressions  in 
the  mind  of  the  patient  became  a  unity  before  which  another 
negation  could  be  placed.  She  would  say,  "  It  is  not  not-ugly,"  in 
order  to  say  that  something  was  ugly.  The  "  not-not-ugly  "  was 
used  as  one  expression  and  used  with  a  negative  to  express  some- 
thing that  was  beautiful.  It  is  conceivable,  that  the  patient  easily 
became  confused  and  was  no  longer  clear  whether  she  affirmed 
or  denied  something;  then  held  the  listener  responsible  for  puz- 
zling her. 

Negativism  in  the  transference  of  words  heard  into  the  cor- 
responding thoughts  has  not  yet  been  observed  by  me.  It  is  cer- 
tainly not  rare  that  the  patients  understand  the  opposite  of  what 


THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM  9 

we  say.  That  is,  however,  only  the  case  when  this  opposite  is 
identical  with  their  delusions  and  wishes.  The  cases  known  to 
me  are  therefore  ordinary  examples  of  illusions  of  perception 
and  memory. 

It  is  a  very  important,  and  yet  an  often  overlooked  character- 
istic of  negativism,  that  it  does  not  show  itself  uniformly,  but  at 
times  is  present  and  at  times  absent  in  accordance  with  the  psy- 
chical constellation.  It  is  quite  usual  that  patients  in  their  relations 
with  other  patients  and  with  the  attendants  appear  free  from 
negativism,  but  on  the  contrary,  they  are  very  refractory  to  the 
physicians  and  their  regulations.  The  reverse  is  not  quite  so 
common.  To  visitors  also  the  conduct  may  be  the  contrary  of 
the  usual.  Certain  patients  become  suddenly  negativistic  when 
one  touches  a  complex.  Others,  on  the  contrary,  under  the  same 
circumstances,  may  lose  their  negativism  for  a  time. 

What  we  have  thus  far  designated  as  negativism  must  appear, 
after  the  mere  description,  to  be  a  symptomatological  collection, 
made  up  of  very  different  things,  and  after  it  has  been  pointed  out 
that  the  genesis  of  all  these  phenomena  is  not  uniform,  one  may 
ask  why  all  this  is  included  in  one  conception.  Not  from  respect 
for  the  teachings  of  the  past,  but  because  we  are  not  yet  able  to 
distinguish  between  the  various  psychic  processes  which  call  forth 
negativism.  The  most  varied  manifestations  may  be  derived 
from  the  same  roots,  and  all  the  varieties  mentioned  may  occur 
in  the  same  patient  in  such  mixtures  and  transitions  that  one  will 
never  be  able  clearly  to  separate  them. 

It  is  self  evident  that  inner  negativism  can  assert  itself  out- 
wardly in  negativistic  acts.  He  who  instead  of  "  agreeable " 
thinks  "  disagreeable,"  must  act  wrongly,  and  will-negativism  may 
lead  to  the  same  inaction  or  to  contrary  action  as  mere  defense 


lO  THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM 

to  outside  factors.  On  the  other  hand  the  repelling  of  outer  in- 
fluences causes  an  inversion  of  the  feeling  tone,  which  evidences 
itself  as  inner  negativism.  The  offering  of  food  often  causes 
disagreeable  feelings,  just  because  it  comes  from  without;  the 
declining  then  is  obvious.  But  the  disturbance  should  be  sought 
in  the  negativistic  vitiated  emotional  reaction  rather  than  in  the 
relation  to  the  external  world.  This  cannot  be  entirely  denied 
because  pararythmic  reactions  are  not  altogether  infrequent  in 
dementia  prascox. 

Negativism  is  thus  not  an  elementary  symptom,  but  a  collec- 
tive idea,  comprising  a  number  of  symptoms,  which  are  similar 
one  to  another,  in  that,  in  the  different  areas  of  psychic  activity 
precisely  that  is  left  undone  or  the  contrary  is  done  which  one 
would  otherwise  expect  under  the  existing  conditions.  Nega- 
tivism most  commonly  involves  a  repelling  of  outside  influences; 
it  can  express  itself,  however,  as  an  inhibition  or  perversion  of 
inner  processes.  Not  even  the  repelling  of  outside  influences  is 
always  founded  on  the  same  genesis,  and  in  a  given  case,  we  shall 
see,  several  motives  operate  together,  in  order  to  bring  about  the 
repulsion. 

The  idea  of  negativism  is  not  always  limited  in  this  way. 
Kraepelin^  describes  it  under  the  title  of  weakened  influence  of 
the  will  and  designates  it  as  "the  instinctive  resistance  against 
every  outer  influence  of  the  will."  This  expresses  itself,  accord- 
ing to  the  author,  in  seclusion  against  outer  impressions,  in  in- 
accessibility to  every  outer  communication,  in  resistance  to  every 
demand,  which  can  culminate  in  the  systematic  performance  of 
exactly  opposite  actions.  The  latter  is  not  always  simply  an 
exaggerated  opposition,  a  "  weakened  influence  of  the  will,"  but 

'  Psychiatric,  8.  Aufl.,  I,  380.     Barth.     Leipzig,  1909. 


THE  THEORY  OF  SCHIZOPHRENIC   NEGATIVISM  II 

probably  a  suggestibility  in  a  negative  sense.  Kraepelin  does 
not  mention  inner  negativism  explicitly  as  belonging  to  nega- 
tivism :  yet  for  him  the  blocking  of  the  will  is  only  a  partial  ex- 
pression of  general  negativism.  The  Kraepelinian  idea  of 
blocking  is  composed  of  two  different  things.  What  we  mean 
by  this  name  is  a  sudden  arrest  of  psychic  events  that  is  often 
observed  in  thinking.  It  is  one  of  the  usual  schizophrenic  symp- 
toms and  has  its  analogy  in  the  arrest  of  thought  in  the  healthy 
which  is  produced  by  some  affect  (terror,  examination  fright). 
Such  blocking  in  thought  and  will  may  also  occur  in  the  absence 
of  negativism,  but  negativistic  disturbance  of  the  will  is  condi- 
tioned by  a  contrary  will,  an  "  opposition."  It  is  therefore  fun- 
damentally different  although  the  two  causes  may  occasionally 
overlap  as  the  negativism  is  also  colored  with  affect. 

It  appears  to  us  that  Kraepelin  has  laid  too  much  weight  on 
the  seclusion  from  outer  impressions.  There  are  negativistic 
patients  who  are  interested  in  everything,  who  tease  others  and 
generally  seek  stimuli  from  without.  The  schizophrenic  repell- 
ing of  outside  influences  ("Autismus,"  see  below)  does  not 
necessarily  express  itself  in  a  sensory  declining,  but  only  in  the 
selection  of  the  impressions  and  their  elaboration. 

Hoche'  defines  negativism'  as  "  the  systematic  resistance 
against  external  influencing  of  the  will  and  also  against  impulses 
arising  from  within."  Here  we  must  replace  the  "systematic" 
that  implies  too  much  conscious  activity  by  "  instinctive "  or 
"  impulse-like."  As  Kraepelin  rightly  says,  no  intellectually  under- 
stood motives  play  a  part.  Further  "  systematic  "  can  not  indicate 
a  continuous  type  of  conduct  for  the  negativism  does  not  appear 
at  every  opportunity,  and  it  may  be  added,  that  the  resistance 

•In:  Binswanger  und  Siemerling,  Lehrbuch  der  Psychiatric.  Fischer, 
Jena,  1904.     S.  258. 


12  THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM 

may  lead  to  the  doing  of  the  opposite.     Furthermore,  the  defini- 
tion also  ignores  intellectual  negativism. 

The  behavior  of  the  psyche  of  the  patient  towards  the  nega- 
tivistic  symptoms  is  very  variable.  They  may  be  fully  united 
with  the  conscious  psyche;  the  patients  are  then  conscious,  re- 
fuse voluntarily  and  then  are  irritable  if  one  desires  something 
of  them,  exactly  like  a  well  person,  who  wishes  to  know  nothing 
of  his  environment.  At  the  other  extreme  the  negativistic  ac- 
tivities emerge  from  the  unconscious  (as  the  voices  and  delu- 
sions) ;  the  patients  are  themselves  surprised  by  them;  they  even 
defend  themselves  against  them  for  some  time;  they  wish  to  be 
agreeable,  to  follow  orders,  but  are  not  able  to  do  so.  Contrary 
impulses  and  inhibitions  of  all  sorts  prevent  the  patients  from 
doing  what  they  have  in  view,  so  that  commonly  they  believe  in 
the  influence  of  a  strange  force.  All  gradations  intervene.  So 
long  as  the  patients  are  left  alone  they  generally  relate  them- 
selves very  well  to  the  surroundings,  and  may  resolve  that  they 
will  not  now  react  negativistically ;  when  the  opportunity  occurs, 
however,  they  are  protesting  and  irritated ;  they  themselves  won- 
der at  such  changes  of  mood  and  affect  and  can  not  discuss  the 
matter. 

An  attempt  has  been  made  to  explain  negativism  by  pro- 
ceeding from  the  motility,  from  muscular  disturbances.  Lund- 
borg*  finds  a  similarity  between  the  catatonic  muscle  phenomena 
and  myotonia  and  thinks,  that  many  patients  in  spite  of  wishing 
to,  cannot  move  and  therefore  are  apparently  negativistic.  He 
even  brings  the  stereotypies,  which  lead  to  round-about  imprac- 
ticable movements,  into  relation  with  this  disturbance.     This  par- 

*Beitrag  zur  klin.  Analyse  des  Negativisums  bei  Geisteskranken. 
Zentralblatt  f.  Nervenkrankh.  und  Psychiatric,  1902,  S.  554. 


THE   THEORY   OF    SCHIZOPHRENIC    NEGATIVISM  1 3 

allel  with  myotonia,  shows  that  the  author  transposes  the  root  of 
negativism  to  a  centrifugal  process,  and  thinks  of  this  at  least 
as  peripheral;  that  the  departure  of  the  motor  stimulus  starts 
from  the  cortex,  or  possibly  even  in  the  muscles.  I  do  not  want 
to  deny,  that  the  outer  picture  of  negativism  may  be  produced 
through  not  being  able  to  act,  but  not  through  a  motor  hindrance, 
but  as  the  result  of  a  psychic  interference,  like  a  child,  who  is 
bashful  before  a  stranger,  from  whom  he  can  not  take  a  bonbon, 
even  though  anxious  for  a  sweet. 

We  have  to  do  then  with  the  inhibition  of  a  purpose  brought 
about  by  a  contrary  affect.  This  also  occurs  naturally  in  schizo- 
phrenia, but  it  is  probably  preferable  not  to  call  this  phenomenon 
negativism  in  spite  of  the  external  resemblance.  In  spite  of  all 
my  effort  I  have  been  unable  to  see  a  true  motor  disturbance  in 
dementia  prsecox  either  at  the  root  of  negativism  or  elsewhere. 
At  all  events  there  is  nothing  to  observe  in  many  cases  with  nega- 
tivism that  one  could  even  remotely  explain  as  a  motor  symptom ; 
for  many  hyperkinetic  patients  are  negativistic  and  vice  versa  the 
negativistic  reactions  frequently  lead  to  very  energetic  and  active 
muscular  movements.  The  hypothesis,  at  best,  can  have  only 
limited  validity. 

R.  Vogt^  discusses  this  theory  but  definitely  localizes  the 
difficulty  of  action  in  the  motor  centers.  According  to  him  there 
persists  (as  in  the  catatonic  brain)  a  tendency  to  perseveration 
which  manifests  itself  especially  in  the  antagonists.  In  this  way 
movements  are  made  difficult,  and  this  condition  produces  in  the 
psyche  a  disinclination  to  movements  in  general. 

In  view  of  the  general   disassociation  of  the  schizophrenic 

psyche,  the  undoubtedly  common  tendency  to  perseveration  might 

*  Zur  Psychophysiologic  des  Negativisums,  Zentralblatt  f.  Nervenheillc 
u.  Psychiatric,  1903,  S.  85. 


14  THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM 

be  assumed  to  affect  especially  the  antagonists  in  individual  cases ; 
but  no  one  has  yet  observed  it.  But,  negativism  never  stands  in 
a  definite  quantitative  ratio  to  the  degree  of  perseveration,  and 
above  all,  those  cases  do  not  escape  where  there  is  no  trace  of 
perseveration,  and  in  which  the  movements  are  in  no  way  im- 
peded.    So  Vogt's  view  can  not  be  right. 

Roller^  has  already  expressed  similar  ideas  to  those  of  Lund- 
borg  and  Vogt,  as  he  likewise  sought  to  derive  the  negativistic 
"will  not"  from  a  "can  not"  as  the  result  of  disturbances  of 
innervation  and  besides  conceived,  that  the  contraction  of  the 
antagonists  by  way  of  their  "  re-innervation  "  called  forth  the  will 
to  contrary  action. 

Alter'^  also  considers  negativism  a  motor  phenomenon.  His 
"primary  negativism"  springs  from  schizophrenic  tonic  rigidity. 
He  assumes,  as  fundamental,  a  molecular  alteration  in  the  ner- 
vous system  produced  by  toxins  which  makes  possible  sej  unction 
in  the  paths  of  the  protagonists.  The  exciting  cause  of  the  se- 
j  unction  is  the  attention,  which  easily  inhibits  what  one  wills. 
Through  the  sejunctive  inhibition  in  the  protagonist  paths  the 
impulse  is  directed  to  the  antagonists. 

The  existence  of  a  catatonic  tonus,  as  a  true  motor  symptom 
is  to  me  very  questionable.  My  positive  observations  are  limited 
to  motor  phenomena  elicited  by  psychic  factors  and  which  are 
again  removable  by  psychic  means.  On  the  other  hand  one  often 
feels  a  mild  resistance  in  the  passive  movements  of  schizophre- 
nics even  when  the  patient  willingly  surrenders  himself  to  all  ex- 
periments.    One  cannot  deduce  negativism  from  this,  as  a  strong 

*  Motorische  Storungen  bei  einfachem  Irresein,  Allgem.  Zeitschrift  f. 
Psychiatric,  Bd.  42,  S.  i. 

''  Zur  Genese  einiger  Symptome  in  katatonen  Zustanden.  Neurol.  Cen- 
tralbl.,  1904,  S.  8. 


THE   THEORY   OF    SCHIZOPHRENIC    NEGATIVISM  I  5 

resistance  is  precisely  the  result  and  not  the  cause  of  the  psychic 
reluctance. 

Active  negativism  can  not  be  interpreted  anyhow  by  a  round- 
about way  through  the  antagonists.  The  innervation  of  the  an- 
tagonists makes  no  retrogression  from  a  progression,  nor  does  it 
make  a  "no"  from  a  spoken  or  written  "yes."  All  of  this  re- 
quires quite  special  muscular  coordinations. 

The  theories  which  explain  the  unwillingness  to  act  by  a  motor 
difficulty,  and  which  deduce,  from  the  innervation  of  the  antag- 
onists, the  idea  and  the  will  to  an  opposite  action,  are  certainly 
wrong;  in  the  first  place,  because  a  motor  difficulty  for  the  most 
part  does  not  exist,  and  if  it  did,  it  would  not  be  able  to  produce 
the  motor  phenomena  of  negativism ;  in  the  second  place,  because 
innervation  of  the  antagonists  only  exceptionally  leads  to  a  con- 
trary action. 

Wernicke*  considers  negativism  and  pseudo-flexibilitas  as 
modifications  of  flexibilitas  cerea,  "which  appear  with  retained 
possibility  for  any  voluntary  influence."  The  attempt  at  pas- 
sive movement  is  perceived  within  the  cortex.  At  times  it 
arouses  the  idea  of  the  movement  to  be  executed  and  renders 
easier  the  corresponding  action  of  the  will,  at  other  times  the 
thought  of  the  impossibility  of  executing  the  movement  arises, 
that  is,  to  the  idea  of  the  movement  to  be  executed  is  associated 
at  the  same  time  the  inhibiting  thought  of  an  expected  outlay  of 
strength,  which  appears  very  great  in  the  subjective  estimation. 
The  effect  of  the  will  thereby  becomes  reversed.  Why  at  one 
time  negative,  and  at  another  time  positive  ideas  are  awakened  is 
not  explained  by  this  theory,  just  as  it  does  not  explain  why  a 
passive  movement  should  ever  arouse  ideas  of  the  impossibility 

*  Psychiatric,  Aufl.  I,  S.  453. 


l6  THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM 

of  executing  the  movement  and  of  the  expected  outlay  of  force, 
and  still  less,  how  out  of  it  can  come  the  exhibition  of  strength 
of  an  often  energetic  resistance.  The  hypothesis  forgets  alto- 
gether, that  only  a  small  part  of  the  negativistic  phenomena  is 
expressed  as  resistance  to  passive  movements,  while  expressions 
of  protest,  contrary  actions,  and  cross  impulses  are  much  com- 
moner. Also  when  one  puts  instead  of  "  passive  movements " 
"any  demanded  movement,"  this  view  is  not  rendered  any  more 
plausible.  We  would  have  to  find  occasionally  the  idea  of  im- 
practicability and  demand  for  effort  at  the  root  of  negativism. 
This  I  have  never  found.  We  see  on  the  contrary  aversion 
to  mental  or  physical  effort  quite  commonly  without  connection 
with  negativistic  expressions ;  one  symptom  may  be  lacking,  while 
the  other  is  present,  and  where  both  are  found  together,  one  no- 
tices no  parallelism  in  their  intensity. 

For  the  comprehension  of  Wernicke,  his  further  view,  ac- 
cepted by  others,  is  significant,  that  a  partial  negativism  occurs  in 
single  muscle  groups.  Observation  has  never  given  me  any 
proofs  for  such  an  assumption.  I  have  learned  to  know  negativ- 
ism only  as  a  psychic  phenomenon,  with  its  expressions  governed 
by  ideas,  not  by  anatomical  conditions.  Also  I  have  been  able, 
up  to  now,  to  localize  the  motor  phenomena  of  schizophrenia  only 
in  ideas,  although  obliged  to  assume,  that  one  of  the  predisposing 
causes  lies  outside  the  psychic  area.  (Perhaps  something  akin 
to  brain  torpor?). 

The  psychic  theories  of  negativism,  for  the  most  part,  have  no 
regard  for  the  irregularity  of  its  expressions.  Thus  the  theory 
of  Raggi"  and  Paulhan,  who  assume  a  contrast  association,  bring- 
ing out  an  action  opposite  to  the  one  originally  thought;  or  that 

'  Psych.  Kontrasterscheinungen  bei  einer  Geisteskranken,  Arch.  ital. 
per  le  malatie  nerv.,  Bd.  24,  Ref. ;  Allgem.  Zeitschrift  f.  Psychiatric,  1887, 
S.  58. 


THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM  1/ 

of  Sante  de  Sanctis,^"  in  whose  opinion  the  spirit  of  negation  in- 
herent in  us  outweighs  the  remnant  of  resistance  of  the  ego. 
With  such  "  explanations  "  the  question  is  shelved  behind  a  not 
very  accurate  circumlocution  of  the  phenomena.  Still  less  can 
we  take  up  with  the  assumption  of  a  "  nolition,"^^  so  long  as 
this  idea  is  not  deduced  from  the  elementary  psychic  manifesta- 
tions. 

In  France  and  in  part  in  Italy,  negativistic  phenomena,  are 
frequently  grouped  with  nihilistic  ideas,  and  explained  under 
the  name  of  "  ideas  of  negation."  Naturally  we  cannot  discuss 
with  these  authors,  as  the  two  symptoms  are  for  us  totally 
different. 

Anton^^  calls  attention  to  the  fact  that  many  hebephrenics 
are  pathologically  suggestible  and  are  more  or  less  aware  of  it; 
they  utilize  therefore  an  elaborate  refusal  as  a  kind  of  psychic 
self  regulation,  as  a  protection  against  unpleasant  influences. 
For  this  reason  negativism  makes  a  distinction  between  superior 
persons  and  such  as  are  of  equal  or  of  lower  station  than  the 
patient,  in  that  it  expresses  itself  more  fully  towards  the 
former.  Negativistic  behavior,  apart  from  schizophrenia  is  fre- 
quently noted  also  by  us  in  genetic  relationship  with  exaggerated 
susceptibility  partly  as  the  second  side  of  the  same  affect  disposi- 
tion which  may  express  itself  positively  and  negatively  partly  as 
an  instinctive  (more  frequently  than  a  conscious)  protective 
measure.  Precisely  in  schizophrenia,  however,  positive  and  neg- 
ative suggestibility  do  not  by  any  means  always  run  parallel,  one 

"  Negativismo  vesanico  e  allucinazioni  antagonistici,  Bull,  della  soc. 
Lancisiana  degli  osped.  di  Roma,  XVI,  96.  Ref.  Zeitschrift  f.  Psych,  u. 
Physiol,  der  Sinnesorgan,  Bd.  13,  S.  397. 

"Centralbl.  f.  Nervenhkd.  u.  Ps.,  1906,  622  (Dromard). 

"  Nerven-  und  Geisteserkrankungen  in  der  Zeit  der  Geschlechtsreife, 
Wiener  klin.  Wochenschrift,  1904,  S.  1 161. 


1 8  THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM 

with  another,  in  course  and  stren^h.  We  believe  that  such  fac- 
tors essentially  cooperate  in  the  origin  of  negativism,  but  that 
the  symptom,  however,  must  have  still  other  and  indeed  more 
important  roots. 

Schiile^^  assumes  a  "  contrary  direction  of  the  will,"  which  is 
conditioned  through  anxious  helplessness ;  it  expresses  itself  first 
in  simple,  then  in  contrary  (active)  negativism.  This  "anxious 
helplessness "  is  too  commonly  wanting  in  negativistic  patients 
for  us  to  deduce  the  phenomenon  from  it.  Yet  there  is  some- 
thing true  also  in  this  conception,  in  so  far  as  lack  of  understand- 
ing of  the  environment  usually  leads  to  negativistic  reactions, 

Gross^*  refers  first  to  the  helplessness  as  causing  the  "  affect 
state  of  negation."  This  alone,  or  in  conjunction  with  inhibition, 
produces  a  form  of  negativism.  According  to  him,  there  is,  how- 
ever, in  addition  a  "  true  catatonic  (psychomotor)  negativism," 
that  is,  "  a  complex  of  phenomena,  which  form  the  expression  of 
a  series  of  psychophysical  processes  separated  from  the  con- 
tinuity of  the  ego,  in  no  way  related  with  the  psychic  processes  of 
the  conscious  personality,  and  therefore  inaccessible  to  any  intro- 
spective after  contemplation."  There  is  thirdly  a  "psychic"  or 
"  total "  negativism,  which  is  compounded  of  the  two  first  forms. 
The  conception  of  the  second  form  can  not  be  correct.  While 
it  is  true  that  schizophrenic  psychisms  can  functionate  fully  disso- 
ciated from  the  ego-complex,  this  does  not  answer  the  question 
why  precisely  such  phenomena  become  negativistic.  In  reality 
such  psychic  automatisms  can  be  negativistic  or  not,  in  the  same 

"  A.  Zeitschrift,  Bd.  58,  S.  226. 

"  Die  Affektlage  der  Ablehunng.  Monatsschrift  fur  Psychiatric  und 
Neurologic,  1902,  Bd.  XII,  S.  359.  Beitrag  zur  Pathologic  dcs  Nega- 
tivisums.  Psychiatrisch-neurol.  Wochenschrift,  1903,  V.  Jahrg.,  S.  269. — Zur 
Differential-Diagnostik  negativistischer  Phanomcne.  Psychiatr.-Neurol. 
Wochenschrift,  1904,  Bd.  VI,  S.  345. 


THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM  1 9 

manner  as  conscious  functioning  processes.  On  the  other  hand 
the  idea  of  an  "  affect  state  of  negation  "  contains  an  element  of 
truth  although  it  is  not  a  genetic  explanation  of  negativism.  One 
can  ascribe  to  all  these  negation  processes  a  common  component, 
the  negation,  and  the  negation,  as  with  all  conflicts,  is  associated 
with  an  affect,  so  that  the  term  cannot  be  entirely  repudiated  as  a 
circumlocution  of  the  affective  volitionistic  part  of  the  nega- 
tivism. However,  the  idea  is  not  at  all  clear,  and  keeping  in 
mind  the  different  moods  in  which  negativistic  symptoms  appear, 
the  identity  of  the  affective  phenomena,  grouped  together  as  the 
"  affect  of  negation,"  must  be  doubted. 

Kleist^^  also  assumes  a  peculiar  "  feeling,"  which  he  parallels 
with  the  "  feelings  of  anxiety,  of  anger,  of  joy,"  thus,  according 
to  our  terminology,  an  affect  is  made  the  foundation  of  the  nega- 
tivism. In  some  cases  it  is  expressed  as  a  painful  sensation  of 
weakness  in  the  heart,  in  others  as  an  unmotived  anxiety.  Why 
it  appears,  the  author  leaves  unexplained,  but  that  is  precisely 
what  we  wish  to  know.  I  must  again  raise  the  objection  that  I 
have  not  been  able  to  make  out  a  "  peculiar  characteristic  feel- 
ing" that  was  the  same  in  each  case  of  negativism. 

On  close  examination  the  same  grounds  will  be  found  as 
causes  of  pathological  negativism  as  for  the  negative  attitude  in 
health.  First  one  repulses  when  one  does  not  wish  to  be  dis- 
turbed. This  is  also  regularly  the  case  in  schizophrenic  nega- 
tivism.    All  these  patients  are  highly  "  autistic,""  that  is,  turned 

"  Weitere  Untersuchungen  von  Geisteskranken  mit  psychomotorischen 
Storiingen.    Leipzig,  Klinkhardt,  1909,  S.  97  f. 

"  By  autistic  I  understand  practically  what  Freud  (not  however  Have- 
lock  Ellis)  means  by  autoerotism.  I  think  it  well,  however,  to  avoid  the 
latter  expression,  as  it  is  misunderstood  by  all  those  not  very  familiar  with 
Freud's  writing.  I  have  discussed  this  at  length  in  the  chapter  on 
Schizophrenia  in  Aschaffenburg's  Hand-Bookof  Psychiatry.  The  symptom 
of  ambivalence  to  be  mentioned  later  in  the  text  is  also  discussed  in  this 
book. 


20  THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM 

away  from  reality;  they  have  retired  into  a  dream  life,  or  at  least 
the  essential  part  of  their  dissociated  ego  lives  in  a  world  of 
subjective  ideas  and  wishes,  so  that  to  them  reality  can  bring  only 
interruptions.  Many  patients  state  this,  with  full  consciousness, 
to  be  the  reason  for  their  behavior.  They  wish  to  remain  undis- 
turbed within  themselves,  and  so  it  is  apt  to  vex  them  extremely 
if  the  attendant  merely  comes  into  the  room  to  bring  food.  Their 
stereotypies,  their  peculiar  attitudes  and  other  quirks  have  special 
relation  to  their  complexes :  for  them  they  are  often  the  realized 
fulfillment  of  their  wishes;  they  are  not  only  symbols  of  their 
happiness,  as  one  might  approximately  conceive  from  the  stand- 
point of  health,  but  they  are  the  essential  part  of  happiness  itself. 
They  have,  therefore,  grounds  enough  to  defend  themselves 
against  anything  likely  to  rob  them  of  this  treasure. 

It  is  self  evident  that  autism  does  not  express  itself  merely 
in  centripetal  relations  to  the  outer  world.  There  are  two  reasons 
for  this :  The  patient  who  wishes  to  isolate  himself  from  reality 
must  permit  the  environment  to  act  upon  him  as  little  as  possible, 
but  he  must  also  not  wish  to  influence  it  actively  himself.  For 
two  reasons :  By  doing  so  he  would  become  distracted  from 
within  and  obliged  to  heed  the  external  world  so  as  to  be  able 
to  act  upon  it;  furthermore,  through  the  action  himself  he  would 
create  new  sensory  stimuli  and  other  relations  with  reality.  The 
autistic  and  negativistic  patients  are  therefore  mostly  inactive  ;^'^ 
they  have  actively  as  well  as  passively  narrowed  relations  with 
the  outer  world. 

"  Under  special  circumstances  this  seclusion  may  be  overcome  as  in 
the  acute  hyperkinesias,  in  which  the  movements  result  from  an  impulse, 
and  in  paranoids,  who,  while  the  autism  is  not  fully  complete,  are  sensible 
of  the  interference  with  their  wishes,  and  translate  them  into  delusions  of 
persecution  and  react  accordingly.  In  both  cases  there  is  a  much  nar- 
rowed relation  to  the  outer  world. 


THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM  21 

But  the  autistic  patients  have,  not  alone,  a  positive  reason  for 
busying  themselves  undisturbed  with  their  own  ideas  where  they 
see  their  wishes  fulfilled.  The  imagined  happiness  is  not  abso- 
lute. It  is  destroyed  not  only  through  the  influences  of  the  outer 
world  and  the  conception  of  reality,  but  in  its  place  appears  much 
oftener  at  once  under  such  circumstances,  the  sensation  of  the 
opposite,  of  the,  in  reality,  unfulfilled  wish.  All  these  patients 
have  a  life  wound,  which  is  split  off  from  the  ego  as  well  as  may 
be,  and  hidden  by  an  opposite  conception.  For  that  reason  they 
must  defend  themselves  agamst  any  contact  with  their  complex; 
and,  as  in  the  splitup  thought  process  of  the  schizophrenic,  every- 
thing, so  to  say,  may  have  its  association  to  the  complex,  so  every- 
thing may  be  painful  to  them  that  comes  from  the  outside.  This 
genesis  of  negativistic  phenomena  may  often  be  established 
through  observation  or  direct  experiment  when  touching  of  the 
complexes  calls  forth  the  negativism,  where  it  would  not  other- 
wise appear. 

With  this  conduct  the  patients  exaggerate  and  caricature  only 
one  of  the  usual  manifestations  of  the  normal.  It  is  a  general 
experience,  that  questions,  which  relate  to  complexes,  are  at  once 
answered  in  the  negative,  even  when  the  persons  wish  to  be  open, 
and  afterwards  speak  of  it  without  dissembling.  For  there  exists 
an  instinctive  tendency  to  conceal  the  complex.  Normal  persons, 
likewise  see  to  it  that  their  life's  wound  is  not  touched  upon,  and 
they  also  often  have  in  misfortune  the  tendency,  to  withdraw 
within  themselves,  because  by  contact  with  others  there  are 
so  many  things  that  root  up  the  pains,  by  associations  with  the 
complex.  Even  in  consequence  of  bodily  pains,  which  can  not 
be  relieved,  we  often  see  negativistic  conduct,  especially  in  chil- 
dren, who  under  such  circumstances  draw  back  and  become  re- 


2  2  THE   THEORY   OF    SCHIZOPHRENIC    NEGATIVISM 

pellant  in  the  same  manner  as  our  patients,  sometimes  towards 
all  influences  from  the  outer  world,  sometimes  only  under  special 
conditions. 

Among  children  we  see  still  other  grounds  for  negativistic 
conduct :  they  often  do  not  understand  what  is  expected  of  them 
and  turn  against  the  unknown  through  general  obstinacy,  for  ex- 
ample, during  a  medical  examination,  or  in  being  photographed. 
We  observe  the  same  thing  in  imbeciles,  the  deaf  and  dumb  and 
partially  deaf,  the  dream  state  in  epileptics,  and  in  timid  or  ob- 
stinate animals.  Schizophrenics  also  are  frequently  no  longer 
able  to  understand  the  environment,  and  must  become,  in  the 
same  manner,  cross  and  repelling,  although  in  the  course  of  the 
disease,  the  general  blind  resistance  which  under  normal  condi- 
tions is  to  their  interest,  becomes  a  detriment. 

From  the  standpoint  of  the  patients  the  environment  more- 
over frequently  appears  not  only  not  understandable  but  directly 
inimical ;  at  best  it  does  not  enter  into  their  needs.  We  incar- 
cerate them  in  an  institution,  rob  them  of  their  personal  rights; 
they  do  not  wish  to  concern  themselves  about  the  world,  and  we 
wish  to  force  them  to ;  they  have  ideas  of  grandeur  which  are  not 
recognized ;  they  wish  to  love  without  being  able  to  command  an 
object;  they  are  persecuted  and  find  no  protection,  but  instead, 
misunderstanding  and  refusals. 

In  the  institution  the  physicians  and  attendants  become  the 
incarnations  of  such  disappointments,  while  the  other  patients 
sympathize  with  the  patient  mostly  not  at  all  or  only  superfi- 
cially, and  at  any  rate  stimulate  the  complexes  much  less  than 
the  officers  of  the  institution.  The  relatives  are  sometimes  drawn 
into  the  complexes,  sometimes  not.  The  difference  in  the  effect 
in  the  negativism  towards  different  persons  is  thus  easily  com- 


THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM  23 

prehended.  It  is  just  as  intelligible  that  negativism  will  be  called 
out  or  increased  by  opposition  from  outside,  but  is  dispersed 
through  the  greatest  possible  nonchalance. 

The  affectivity  of  schizophrenia  contains,  furthermore,  an 
additional  root  of  negativism.  In  the  beginning  of  the  disease 
especially  we  can  often  observe  a  more  marked  touchiness  of  the 
affect,  and  there  is  much  to  indicate  the  existence  of,  in  the  later 
course,  a  pathological  irritability.  Under  such  circumstances  we 
see,  in  patients  who  are  not  schizophrenics  ( for  example,  in  neu- 
rasthenics) as  in  schizophrenics  who  are  still  capable  of  social 
relations,  a  drawing  into  themselves,  the  greatest  possible  avoid- 
ance of  all  stimuli  and  a  reaction  to  influences  which  differs  from 
negativism  quantitatively  only.  Naturally  the  negativism  orig- 
inating from  other  sources  produces  on  its  side  an  analogous  un- 
derlying affective  state,  so  that  irritability  and  negativism  to- 
gether form  a  vicious  circle. 

Increased  difficulty  of  action  and  thought  is  a  further  root 
of  negativism  which  is  clear  in  some  cases.  There  are  many 
different  reasons  for  this,  some  of  which  we  probably  do  not  yet 
know.  I  have  not  yet  been  able  to  establish,  as  mentioned,  a 
specific  motor  disturbance.  On  the  contrary  there  are  phenomena 
resembling  brain  pressure.  True  action  is  moreover  impeded  by 
the  disturbed  associations,  most  commonly,  however,  we  find  in 
the  schizophrenics  a  peculiar  inability  to  direct  their  thoughts. 
"  It  thinks  "  in  the  patients.  The  flow  of  thought  is  automatic, 
independent  of  the  will;  often  it  is  felt  as  a  most  painfully  fati- 
guing compulsion ;  often  also  the  pressure  of  thought  is  a  matter 
of  indifference  as  long  as  he  is  left  to  himself.  So  soon,  however, 
as  he  is  forced  by  stimulation  from  without  to  change  the  direc- 
tion of  his  thoughts,  highly  distressing  feelings  arise  in  both 
events,  which  enforce  an  attitude  of  repelling. 


24  THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM 

That  the  negativistic  repelling  very  often  bears  the  outspoken 
stamp  of  the  erotic  must  be  due  to  a  root  of  the  negativism  being 
in  the  sexuality.  This  is  very  easily  understandable.  The  sex- 
uality has  normally  a  strong  negativistic  component;  it  shows 
itself  clearest  in  the  opposition  of  the  female  against  the  sexual 
approach,  which  we  find  in  animals  and  also  in  man,  where  the 
sexual  act  is  desired.^^  We  know  that  there  is  no  case  of  schizo- 
phrenia in  whose  complexes  sexuality  does  not  play  a  prominent 
role,  and  very  often  the  repelling  is  founded  in  sexual  delusions, 
the  patients  believing  themselves  loved  or  violated. 

In  general,  negativism  has  a  close  relationship  to  delusions  and 
hallucinations.  These  can  naturally  not  lead  to  a  true  negativism 
but  to  conduct,  that  can  not  at  all  be  differentiated  directly  from 
negativism,  and  as  delusions  and  negativism,  for  the  most  part, 
appear  side  by  side,  it  is  wholly  impossible,  to  separate  the  part 
played  by  one  factor  from  that  played  by  the  other.  The  diffi- 
culty is  increased  through  the  fact  that  delusions  and  especially 
hallucinations  are  often  the  sequelae,  or  better,  the  expression  of 
negativism ;  the  voices  do  not  necessarily  express  the  negativistic 
state  of  feeling  but  may  correspond  to  another  affect.  Indeed 
very  frequently  the  delusion  is  stated  by  the  patient  afterwards 
falsely  as  the  reason  for  the  negativistic  conduct.  A  young 
woman,  with  whom  during  a  paroxysm,  one  could  establish 
fairly  good  communication  in  spite  of  the  negativism,  declared 
afterward,  however,  that  she  thought  some  one  tried  to  hypnotize 
her  and  then  offer  violence  to  her,  on  that  account  she  had  always 
done  the  opposite  of  what  was  desired  of  her. 

"This  opposition  lies  apparently  at  the  bottom  of  the  aversion  of  the 
cultured  to  think  or  speak  of  sexual  things.  I  certainly  do  not  underrate 
the  role  of  artificial  convenience ;  this  convenience,  however,  which  leads  to 
so  much  disadvantage  and  nonsense,  must  be  grounded  in  our  nature, 
otherwise  it  would  not  have  developed. 


THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM  2$ 

Up  to  this  point  the  description  has  dealt  with  passive  nega- 
tivism which  opposes  itself  against  any  demand  coming  from  out- 
side. The  resistance  leads  naturally  to  active  defense,  abuse,  and 
to  blows,  but  the  doing  of  the  opposite  of  what  is  demanded  re- 
quires a  special  motivation  which  in  part  suggests  itself.  He  who 
will  not  open  the  mouth  on  request,  voluntarily  clenches  his  jaws; 
he  who  answers  to  the  request  to  go  forward  by  walking  back- 
wards, is  best  guarded  against  a  sudden  surprise  which  might  in- 
sist upon  the  carrying  out  of  the  command ;  he  who  will  not  sit 
in  a  certain  place  indicated  sits  better  in  another ;  he  who  will  not 
eat  his  own  portion  must  take  another's  or  go  hungry.  In  short, 
the  opposite  action  is  in  most  cases  so  nearby,  so  self  evident,  it 
so  emphasizes  the  denial  and  provides  such  a  good  position  of 
defence,  that  it  is  very  apt  to  be  used  instinctively  by  both  man 
and  animals. 

Not  rarely,  however,  the  contrary  action  so  far  overshoots 
the  mark  that  the  hitherto  utilized  motive  for  its  explanation  is 
no  longer  sufficient.  Thus  a  patient,  who  wishes  to  go  to  bed  and 
has  undressed,  receiving  a  careless  command  from  the  attendant 
to  go  to  bed,  at  once  begins  to  put  his  clothes  on  again.  By  error 
a  patient  is  given  cabbage,  among  other  things,  on  her  plate,  when 
it  is  well  known  that  she  does  not  like  it.  As  she  usually  gets 
no  dessert,  unless  she  has  finished,  she  is  told  she  need  not  eat 
the  cabbage ;  now  she  eats  only  the  cabbage  and  leaves  the  other 
better  liked  things  on  her  plate.  This  same  catatonic  plays  the 
piano ;  as  soon  as  she  notices  that  she  is  listened  to  with  pleasure, 
she  stops ;  she  looks  curiously  at  everything  unusual,  but  at  once 
turns  away,  however,  if  anyone  pays  any  attention  to  her.  When 
she  hears  an  accidental  remark :  "  Now  she  is  doing  that,"  she 
stops  at  once,  or  does  the  opposite. — Here  belong  also  the  for- 


26  THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM 

bidden  actions.  There  are  patients  who  will  do  nothing  except 
what  is  forbidden  them,  so  that  one  can  make  use  of  this  peculiar- 
ity.— Or  the  patient  will  not  carry  out  an  action  until  it  is  too 
late  or  is  no  longer  possible.  So  it  is  quite  usual  that  they  first 
draw  back  the  hand  that  they  should  reach  out  but  at  once  ex- 
tend it  as  soon  as  one  turns  away  from  them,  or  that  they  give 
no  answer  so  long  as  one  busies  himself  with  them,  but  begin 
to  speak  when  one  turns  to  other  patients  or  when  one  is  about 
to  leave  the  room.  It  may  also  happen  that  schizophrenics  will 
speak  for  others  but  are  dumb  when  asked  questions  themselves 
(whether  indifferent  or  important  is  irrelevant),  or  when  they 
might  have  wishes  of  their  own  to  express. 

In  these  cases,  in  which  the  negativism  leads  to  actions,  of 
course  those  explanations  no  longer  suffice  which  explain  it  with 
the  need  for  rest  or  the  difficulty  of  the  procedure.  The  inimical 
relation  of  the  environment  could  rather  be  considered  as  the 
root  for  such  conduct,  but  it  is  absent  in  many  such  cases  and 
shows  no  parallelism  with  negativism  where  it  is  present.  There- 
fore, there  must  be  still  other  causes  of  negativism. 

The  tendency  to  generalization  of  single  symptoms,  always 
demonstrable  in  schizophrenia,  first  suggests  itself.  Stereotypies, 
resistances,  etc.,  which  are  well  founded  in  some  occasion,  read- 
ily expand  and  become  fixed,  or  at  least  come  to  light  on  many 
occasions  where  they  are  out  of  place. 

A  schizophrenic  may  be  imagined  as  so  working  up  his  eva- 
sions, that  he  carries  them  out  when  the  situation  does  not  de- 
mand it  and  in  a  manner  which  is  in  contradiction  with  his  orig- 
inal (unconscious)  object.  I  do  not  know  how  often  negativistic 
symptoms  are  to  be  explained  in  this  manner,  but  when  one 
closely  observes  the  individual  patients,  one  gets  the  impression 


THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM  2/ 

that  the  tendency  to  generalization  does  not  commonly  lead  to 
exactly  such  conduct. 

Ambitendency  and  ambivalency  are  of  by  far  greater  signifi- 
cance. Both  of  these  two  related  characteristics,  especially  the 
latter,  are  immeasurably  increased  in  schizophrenia. 

I  formerly,  rather  one  sidedly,  applied  the  term  negative  sug- 
gestibility^® to  the  psychological  fact  that  a  definite  tendency  to 
contrary  or  opposite  action  is  combined  with  every  impulse, 
whether  coming  from  within  or  without.  I  would  now  prefer 
to  designate  the  whole  idea  as  "  ambitendency."  Even  in  health 
the  negative  constituent  often  gets  the  upper  hand;  so  soon  as 
one  has  decided  on  something,  the  feeling  comes  that  one  had 
better  have  done  the  opposite ;  people  with  weak  will  are  there- 
fore prevented  from  acting.  In  the  territory  of  the  unconscious 
the  opposite  impulse  often  runs  counter  to  our  wish.  More 
especially  one  wishes  to  be  potent  on  his  wedding  night,  and  ex- 
actly then  most  commonly,  a  transitory  impotence  occurs.  When 
for  any  reason  the  menses  are  especially  awaited,  then  particu- 
larly they  fail,  etc. 

But  there  are  exceptions.  As  a  rule  the  normal  person  allows 
the  pro  and  con  to  act  together,  as  the  physicist  works  with  two 
forces  in  opposite  directions  in  such  a  way  that  the  resultant  is 
governed  by  the  stronger  impulse.  But,  however,  as  there  are 
always  two  tendencies,  it  needs  only  a  small  disturbance  of  their 
balanced  relations,  in  order  to  bring  out  one  of  them,  and  this  can 
as  well  be  the  negative  as  the  positive  one. 

In  schizophrenia,  however,  several  such  disturbances  are 
present.  It  lies  in  the  character  of  the  disease,  that  the  inter- 
association  of  ideas  is  loosened :  each  thought,  each  tendency  can 

"  Psych.-Neurol.  Wochenschrift,  1904,  VI  Bd.,  Nr.  27/28. 


28  THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM 

exist  for  itself,  without  influencing  the  others  and  being  influ- 
enced by  the  others.  Thus  a  catatonic  seats  herself  at  a  strange 
table,  cordially  assures  those  standing  about:  "have  no  anxiety, 
I  am  going  to  take  nothing,"  serves  herself,  however,  at  the  same 
time  with  sweets  and  chews  with  her  mouth  full.  She,  or  rather, 
something  in  her,  knows  that  she  should  not  help  herself ;  that  it 
is  disagreeable  to  those  about  for  her  to  eat  at  the  table  prepared 
for  the  guests ;  she  therefore  sooths  the  onlookers,  and  imagines 
herself,  as  not  taking  anything,  but  another  component  of  her  split 
psyche  longs  for  the  good  things  and  lays  to.  The  two  psychisms, 
which  in  health  would  be  united  in  an  action  of  choice,  go  along 
here  side  by  side  without  in  the  least  influencing  each  other. 

While  in  the  above  observation  the  two  impulses  have  become 
simultaneously  active  it  is  also  possible  for  only  one  impulse  to 
become  active  at  a  given  moment,  giving  the  other  free  play  to  be 
operative  later  on.  Each  goal  by  itself  may  dominate  the  patient 
for  a  certain  length  of  time  making  him  the  sport  of  his  different 
impulses.  Whether  he  acts  in  a  positive  or  negative  sense  is  a 
matter  of  accident  more  or  less.  Also  an  already  carried  out 
action  can  be  annulled;  as  when  a  patient  destroys  a  fully  com- 
pleted piece  of  work.  The  negative  and  positive  tendencies  can 
also  change  very  quickly,  even  during  the  carrying  out  of  an 
action.  "  Not  seldom  we  observe  a  vacillation  in  the  strength 
of  the  positive  and  negative  tendencies ;  sometimes  one,  sometimes 
the  other,  gains  the  supremacy.  There  comes  a  sudden  stand-still 
and  then,  just  as  suddenly,  a  continuation  of  the  original  move- 
ment; it  continues  by  fits  and  starts  and  becomes  angular  and 
awkward."2« 

Kraepelin  explains  this  by  the  absence  of  the  guiding  influ- 

"  Kraepelin,  Psychiatric,  Achte  Auflage,  I,  373. 


THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM  29 

ence  of  permanent  endeavors  and  volitional  tendencies  upon 
actions.  A  better  expression  would  be  to  say  that  the  goal  is 
constantly  changing.  Gross  seeks  the  pathogeny  in  the  loss  of  the 
"  highest  psychic  function."  The  idea  of  the  latter  is  very  vague. 
The  "  synthesis  "  of  the  different  trends,  an  expression,  which  is 
used  by  the  French  for  a  quite  similar  conception,  is  rather  a 
general  characteristic  of  the  normal  psyche;  naturally,  like  many 
others,  it  can  become  relatively  easily  disturbed,  because  it  is 
proportionally  complicated.  It  is  not  lacking,  however,  in  chil- 
dren, idiots,  or  animals,  only,  corresponding  to  the  greater  sim- 
plicity of  such  psyches,  less  developed.  It  thus  becomes  difficult 
to  designate  this  association  of  different  correlated  ideas  and 
trends,  which  suffers  first  in  schizophrenia,  in  a  unity  as  the  high- 
est psychic  function.  What  we  observe  is  just  the  splitting,  the 
independence  of  single  psychisms,  and  we  will  indeed  do  well, 
in  this  obscure  territory  not  to  go  beyond  the  observations. 

In  schizophrenia  the  stimulus  from  the  outside  produces  quite 
as  easily,  negative  and  positive  reactions :  The  negative  sug- 
gestibility is  pathologically  increased.  The  building  up  of  neg- 
ative and  positive  suggestibility  goes  along,  for  the  most  part, 
hand  in  hand.  Children,  senile  dements,  and  other  sorts  of 
affective  people  are  under  certain  circumstances  very  easily  sug- 
gestible; they  are,  however,  quite  as  often  stubborn  and  negativis- 
tic  against  outer  influences.  Some  authors  have  long  maintained 
that  hysterics  suffer  from  excessive  suggestibility,  while  others 
deny  suggestibility  from  without;  and  refer  it  all  to  autosugges- 
tion. In  reality  both  peculiarities  exist  side  by  side;  they  are 
only  different  sides  of  one  and  the  same  element  of  character. 
Certainly,  the  preponderance  of  protestations,  as  already  men- 
tioned, has,  often  besides,  the  significance  of  a  sort  of  protection 
against  the  exaggerated  suggestibility. 


30  THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM 

In  schizophrenia  especially,  Kraepelin  has  quite  correctly 
brought  negativism  into  relation  with  abnormal  suggestibility, 
which  expresses  itself  in  command  automatism.  We  often  see 
in  the  same  patient  negativism  and  command  automatism  side 
by  side,  indeed  the  one  may  pass  into  the  other.  Schizophrenics, 
like  children,  swing  from  one  extreme  to  the  other.  It  must  be 
added  that  these  two  characteristics  do  not  always  occur  together. 
The  relation,  even  in  schizophrenia,  is  complicated  in  such  a  man- 
ner as  to  resist  reduction  to  a  simple  formula.  Schizophrenics, 
nevertheless,  as  a  whole,  in  spite  of  their  autistic  seclusion  from 
outside,  are  found  to  be  remarkably  suggestible  by  close  examina- 
tion. Fellow  patients  who  are  the  ringleaders  of  a  ward  find  the 
schizophrenics  an  easy  butt,  and  for  the  spiritus  loci  there  is  no 
more  delicate  reagent  for  the  local  color  of  an  institution  than  the 
apparently  isolated  mass  of  its  schizophrenics. 

Kleist^^  denies  the  connection  of  "  negative  suggestibility " 
with  negativism.  This  author  has  the  decided  merit  of  having 
enlarged  upon  Wernicke's  ideas,  of  carrying  them  to  their  end 
and  presenting  them  clearly.  It  is  thus  a  duty  to  come  to  an 
understanding  with  him.  In  the  first  place  he  cavils  at  the  con- 
ception that  inhibition  should  occur  in  the  field  of  motility  as  the 
result  of  the  contrary  conception  which  arises  with  each  idea,  con- 
stituting a  peculiar  disturbance  in  the  course  of  ideation  for 
which  brain  pathology  has  no  analogy.  Here  comes  out  very 
strongly  the  difiference  in  methods  of  investigation.  Brain  pa- 
thology analogies  have  proved  themselves  so  unfruitful  in  psychi- 
atry,^-  that  to  begin  with  we  do  not  care  whether  we  find  thera 

"  Kleist,  Weitere  Untersuchungen  an  Geisteskranken  mit  psychomo- 
torischen  Storungen.    Leipzig,  Klinkhardt,  1909,  S.  97  f. 

^  Cerebral  pathology  and  localization  ideas  have  led  so  extraordinarily 
capable  an  observer  and  fruitful  thinker  as  Wernicke  into  sterile  by-ways. 


THE   THEORY   OF    SCHIZOPHRENIC    NEGATIVISM  3 1 

or  not.  On  the  contrary  we  seek  analogies  in  the  thinking  of  the 
healthy,  and  then  this  so  characteristic  inhibition  shows  itself  to 
be  neither  peculiar  nor  strange.  So  among  the  normal  many 
conclusions  and  actions  are  stopped  in  this  manner  either  tem- 
porarily or  continuously. 

Kleist  further  opposes,  that  to  many  ideas  there  are  no  con- 
trary ideas,  and  that  a  negativistic  patient  who  is  requested  to 
pick  out  the  red  wools  certainly  would  not  choose  the  green.  Here 
the  author  confuses  the  intellectual  contrary  idea  with  the  affec- 
tive— the  voluntary.  We  are  only  considering  the  latter.  Kleist 
moreover  fails  to  consider  that  I  expressly  assume  different  ge- 
netic forms  of  negativism  and  designate  negative  suggestibility  as 
only  one  of  several  roots. 

Ambivalence. — By  ambivalence  is  to  be  understood  the  spe- 
cific schizophrenic  characteristic,  to  accompany  identical  ideas 
or  concepts  at  the  same  time  with  positive  as  well  as  negative  feel- 
ings (affective  ambivalence),  to  will  and  not  to  will  at  the  same 
time  the  identical  action?  (ambivalence  of  the  will)  and  to  think 
the  same  thoughts  at  once  negatively  and  positively  (intellectual 
ambivalence). 

In  the  case  of  an  idea  which  arouses  both  negative  and  posi- 
tive feelings  the  difference  is  not  always  sharply  appreciated  even 
in  health,  or  otherwise  expressed,  when  a  normal  person  loves 
something  or  somebody  on  account  of  one  quality  but  hates  them 
on  account  of  another,  the  result  is  not  an  entirely  unitary  feeling 
tone,  either  the  positive,  or  the  negative  outweighing  at  times.^^ 
The  ultimate  conclusions  are  not  necessarily  drawn  by  the  split 
psyche  of  the  schizophrenic.  The  mentally  sick  wife  loves  her 
husband  on  account  of  his  good  qualities  and  hates  him  at  the 

*^  A  normal  ambivalent  group  of  ideas  is  represented  by  the  sexual, 
especially  in  women,  as  stated  previously. 


32  THE   THEORY   OF    SCHIZOPHRENIC    NEGATIVISM 

same  time  on  account  of  his  bad  ones,  and  her  attitude  towards 
each  side  is  as  though  the  other  did  not  exist. 

Ambivalence  of  the  will  or  voluntary  ambivalence  is  the 
natural  outcome  of  affective  ambivalence.  Intellectual  ambiva- 
lence needs  special  consideration.  It  is  of  course  in  close  asso- 
ciation with  affective  ambivalence  in  many  judgments  but  not  in 
all.  Even  from  the  purely  intellectual  point  of  view  each  thought 
is  in  many  ways  most  closely  akin  to  its  opposite;  not  only  that 
the  closest  association  to  "white"  is  "black":  each  judgment 
contains  the  negation  of  its  opposite,  and  there  would  be  no  sense 
in  thinking  it  unless  the  contrary  had  entered  into  consideration : 
I  can  not  think  and  say :  "  the  sky  is  blue,"  unless  the  contrary, 
that  it  may  not  be  blue,  is,  so  to  say,  in  the  air.^*  Censure  of  a 
picture  lies  psychologically  much  nearer  praise  of  the  picture 
than  any  other  thought.  Children  frequently  use  the  same  ex- 
pressions for  both  positive  and  negative  ideas,  for  example,  tii 
tu  for  Tiire  zu  (door  to)  for  open  and  close  the  door,  also  "  zu- 
letzt"  (last)  for  "zuerst"  (first),  and  later,  when  they  first 
begin  purely  in  play  to  judge,  they  often  do  not  care  at  all  how 
they  express  the  same.'^ 

With  the  confused  schizophrenics  the  distinction  is  often  com- 
pletely blotted  out.  Affective  motives  also  probably  cooperate, 
as  in  the  above  mentioned  patient,  who  at  the  same  time  cen- 
sured and  praised  her  husband;  but  it  is  probably  a  purely 
intellectual   fault  when  a  catatonic  who  after  having  answered 

^* "  Each  idea  demands,  as  it  were,  a  contrary  idea  as  its  natural  com- 
plement." Wreschner,  Reprodnktion  und  Assoziation  von  Vorstellungen, 
Zeitschr.  fiir  Psych,  u.  Phys.  der.  Sinnes-0.,  Erganzungsband  3,  07/9, 
S.  595- 

^  Compare  also  the  latin  "  religio,"  that  was  used  in  both  a  good  and 
a  bad  sense,  as  a  blessing  and  as  a  curse.  Also  see  van  Ginnecken  (Principe 
de  linguistique  psychologique,  Leipzig,  1907),  who  goes  rather  too  far. 


THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM  33 

his  wife's  friendly  letter,  with  an  unmotived  farewell  letter,  said, 
in  answer  to  expostulations:  "I  could  have  just  as  well  written 
another  letter,  good  day  or  farewell  are  just  the  same  "  (dire  bon- 
jour  ou  dire  adieu).  So  thesis  and  antithesis  in  our  patients 
often  become  so  similar  as  to  become  confused  or  even  identified 
one  with  another. 

Ambitendency  and  ambivalency  in  themselves  bring  about  only 
an  equalization  of  correct  thoughts  and  conflicts  with  their  oppo- 
sites.  In  negativism,  however,  these  opposites  actually  gain  the 
ascendant.  There  are  two  known  reasons  for  this:  In  the  first 
place  this  predilection  is  certainly  often  merely  apparent.  Even 
the  negativistic  produces  correct  thoughts  and  actions.  When, 
however,  among  a  thousand  psychisms  in  our  day  only  a  single 
one  is  negativistic  it  is  conspicuous,  the  probability  would  be  that 
in  the  equalization  of  tendency  and  antitendency  there  would  be 
five  hundred  false  to  five  hundred  correct  reactions,  a  proportion 
which  would  imply  severe  negativistic  anomalies. 

Furthermore  the  previously  mentioned  "  contradictions  with 
reality,"  especially  autism,  take  care  that  the  contrary  action  is 
favored  as  much  as  possible. 

Outer  negativism  is  therefore,  in  the  first  place,  due  to  a 
number  of  factors,  which  place  the  patient  in  opposition  to  the 
outer  world;  the  effect  of  this  contrariness  can  become  so  exten- 
sive because  the  schizophrenic  ambitendency  and  ambivalency 
furnish  a  good  soil  for  it,  and  above  all,  remove  what  in  the  nor- 
mal opposes  perverse  actions. 

Ambitendency  and  ambivalency  make  inner  negativism  also 
somewhat  comprehensible  to  us  in  some  degree,  which  would  not 
be  explainable  through  other  factors  which  cause  negation.      When, 


34  THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM 

as  in  will-negativism,  each  impulse  is  opposed  by  a  contrary^*  im- 
pulse, and  when  the  psyche  is  so  split  that  each  of  these  two 
tendencies  can  independently  assert  itself  so  that  a  compromise 
between  them  is  impossible  or  is  made  very  difficult,  then  the 
antitendency  will  often  manifest  itself  instead  of  the  tendency. 
It  has  not  been  positively  demonstrated  that  it  is  just  this  anti- 
tendency  which  asserts  itself  with  especial  frequency.  It  is,  how- 
ever, probable  that  such  cases  occur.  They  would  in  some  de- 
gree be  intelligible  through  the  inner  disruption  in  which  such 
patients  find  themselves.  They  are  not  pleased  with  anything, 
nothing  gives  them  any  satisfaction,  so  it  is  comprehensible  that 
they  seek  something  else ;  and  that  "  something  else  "  is  very  often 
the  opposite. 

I  believe,  however,  that  there  exists  besides  an  unknown  fac- 
tor which  gives  a  special  weight  to  the  contrary  tendency,  not 
only  because  the  observation  of  negativistic  schizophrenics  some- 
times appears  to  point  that  way,  but  also  because  auto-suggestions 
in  the  normal  are  so  frequently  negative;  the  menstrual  period 
arrives  when  it  is  certainly  not  expected  and  vice  versa.  This 
factor  requires  further  study. 

The  cross  impulses  have  very  different  significance.  A  part 
of  them  are,  of  course,  negativistic.  One  will  not  do  the  desired 
and  so  in  some  cases  does  the  opposite;  in  others  only  something 
else.  The  apraxiform  approximate  acts  often  have  the  character 
of  acts  in  emotional  confusion  under  which  circumstances  the 
normal  make  all  sorts  of  errors.  Most  commonly  the  cross  im- 
pulses probably  are  the  result  of  the  specific  schizophrenic  train 
of  thought  in  which  all  at  once  the  nearby  association  becomes  the 

**  The  contrary  impulse  often  consists  in  the  not  carrying  out  of  the 
original  intention.  From  our  view  point  to  do  something  and  not  to  do 
it  is  a  contrast,  just  as  to  do  something  and  to  do  the  opposite. 


THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM  35 

principle  thing ;  the  thought  is  at  once  cut  off  and  there  is  a  new 
one  of  unknown  genesis  or  at  least  of  insufficient  connection  with 
the  preceding;  or  suddenly  a  quite  abrupt  thought,  an  hallucina- 
tion, an  automatic  impulse  to  movement,  suddenly  arises  out  of 
unconscious  complexes.  It  is  sufficient  only  to  hint  at  these 
things  which  are  self  evident  to  one  who  knows  dementia  prsecox. 

Intellectual  negativism  resembles  volitional  negativism  very 
much.  When  an  idea  stimulates  its  opposite  and  the  thought 
becomes  split  and  unclear,  so  that  criticism  is  difficult,  the  antith- 
esis is  apt  to  acquire  undue  weight,  and  under  certain  circum- 
stances replace  the  thesis.  The  latter  especially  because  the 
patients,  with  their  changed  feeling  and  thinking,  are  often  actu- 
ally compelled  to  see  the  thing  in  an  unusual  way.  Nevertheless, 
cases  like  the  one  previously  mentioned,  in  which  each  thought 
compelled  the  thinking  of  a  contrary  thought,  give  cause  for  the 
conjecture,  that  here  preference  escapes  us  as  a  factor  that  leads 
to  the  contrary  thought.  Also  the  dream  of  the  normal,  in  which 
many  an  idea  is  represented  by  its  opposite,  appears  to  me  to  point 
to  an  active  predilection  for  the  negative.  Perhaps  also  the 
mechanism  of  wit,  which  often  replaces  one  thing  by  its  opposite, 
has  a  point  of  contact  with  intellectual  negativism. 

It  has  also  occurred  to  us  that  inner  negativism,  especially  the 
intellectual,  might  express  itself  in  experiments  in  negative  or 
contrast  associations.  This  conjecture  has  not  been  established 
by  proof;  we  have  only  seen  a  striking  tendency  to  contrast  asso- 
ciation in  two  patients,  and  precisely  these  were  not  negativistic. 

R.  Voght^'^  on  the  basis  of  the  views  of  Lipps,  propounds  a 

hypothesis  which  might  explain,  in  hysterics,  how  an  idea  may 

inhibit  precisely  the  closely  related  and  therefore  other  to-be- 

"  Die  hyst.  Dissoziat.  im  Lichte  der  Lehre  von  der  Energie-Absorption. 
Zentralbl.  f.  Nervenheilk.  u.  Psychiatric,  1906,  S.  249. 


36  THE   THEORY   OF   SCHIZOPHRENIC    NEGATIVISM 

anticipated  concepts.  I  believe  the  supposed  identification  of 
transfer  of  energy  and  association  therein  set  forth  is  too  vision- 
ary to  warrant  discussion. 

Inner  negativism  is  much  rarer  in  both  its  forms  than  outer 
negativism.  This  is  easily  understood  after  we  have  seen  how 
much  outer  negativism  is  favored  by  the  disturbed  relations  to 
the  environment,  which  are  constantly  present,  but  favor  will- 
negativism  only  slightly,  and  intellectual  negativism  even  less. 
Negativistic  phenomena  can  not  so  easily  originate,  of  course,  ex- 
clusively upon  the  basis  of  ambitendency  and  ambivalency,  the 
predisposing  factors  of  negativism. 


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